Provider Demographics
NPI:1225259286
Name:RUBIO, CELIA M
Entity Type:Individual
Prefix:MRS
First Name:CELIA
Middle Name:M
Last Name:RUBIO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4101 HASTINGS
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79903
Mailing Address - Country:US
Mailing Address - Phone:915-566-9105
Mailing Address - Fax:915-591-5605
Practice Address - Street 1:4101 HASTINGS
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79903
Practice Address - Country:US
Practice Address - Phone:915-566-9105
Practice Address - Fax:915-592-5605
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11777183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX22478OtherPHARMACY STORE LIC #
TX1740319524OtherSTORE NPI#
TX11777OtherPHARMACIST LIC #
TX145256Medicaid
TX4573007OtherSTORE NABP #
TXBG8143276OtherDEA #